Alan Kohler is one of Australia’s most experienced business commentators. Alan has been a trusted source of investment advice to Australians for many years, and in 2005 he founded Eureka Report - Australia’s #1 online investment report. Along with Robert Gottliebsen and Stephen Bartholomeusz, Alan also founded Business Spectator, the popular business news and commentary website. Alan is the regular finance presenter on the ABC News and producer of the popular nightly graph (or two).

Risking Australia's telehealth future

The current political hoo-ha about how much bandwidth Australians might need in the coming years threatens some of the most important applications of a robust, high-capacity national broadband network. Arguably one of the most critical of these applications is telehealth.

Regardless of which broadband network we end up with, telehealth – which promises to deliver a consistent level of care to patients through remote access to medical care – will be among the biggest beneficiaries.

Market research and consulting group iData expects the Australian telehealth monitoring market to triple in value by 2017, with the broader Asian market exceeding half a billion dollars in that time. Globally the telehealth market is expected to top $US27.3 billion by 2016.

This growth assumes the conditions for telehealth expansion will be met, notably adequate network bandwidth supply to support the exponential growth in data generated by high-definition medical images and video. For patients living hundreds – sometimes thousands – of kilometres away from specialist healthcare resources, an adequate Internet connection can literally become a matter of life or death.

Therein lies the risk of prescribing a less-than-adequate bandwidth quota based on what ‘average Australians’ need. In truth, most of us don’t use the bandwidth we currently have access to on a daily basis. Whether we’re reading the morning papers or streaming music, Australians are, on the whole, rather fortunate in their access to a decent Internet pipe.

But while we contemplate how our usage habits might change over time, mostly from the perspective of what we want to consume, it’s important we don’t lose sight of what we need to consume, and how the future internet could meet those needs.

Without getting too philosophical, tomorrow’s internet will be more important to our quality of life than almost any infrastructure human society has created to date.

One of the biggest contributors to society’s advancement will be telehealth. Already we’re witnessing medical ‘miracles’ on a scale unimaginable only half a decade ago. For example, using little more than a high-speed Internet connection and freely available teleconferencing software, specialist surgeons are helping less experienced colleagues save the lives of disaster victims on opposite sides of the world.

Closer to home, Australia’s urban citizens are spoiled for choice when it comes to easily accessible amenities – shops, entertainment, gymnasiums, civic services. Rural Australians, on the other hand, sometimes have to drive hours for a bottle of milk. The same geographic divide influences access to healthcare.

While a network cannot deliver milk and bread, it can dramatically level the playing field for medical professionals to ensure all of their patients receive a high level of care regardless of where they live.

While it’s safe to say our healthcare centres and healthcare professionals have the foresight – and financial clout – to invest in the best resources available, including internet access, that isn’t always the case for individuals. Networks, by their very nature, are double-ended, so a narrow pipe on one end will always result in bottlenecks, particularly when a large amount of information needs to travel from one end to the other.

As telehealth applications evolve from basic data sharing between medical centres to more advanced real-time, media-rich conferencing between medical centres, doctors’ rooms and patient homes, so the advances in network technology become more important. One of the key challenges of these emerging applications is that most require tremendous amounts of bandwidth if they are to be shared across a healthcare network, let alone delivered down the pipe to the home.

The problem we currently face in Australia is that most of our internet delivery networks are still mired in legacy technology. Leased lines, ATM and frame relay just don’t have the capacity and flexibility to handle high-bandwidth medical and storage applications that are becoming mainstream.

Constant uptime is the first and most basic requirement for telehealth, and even the smallest bottlenecks will result in some degree of downtime. Added to this the high latencies of legacy networks, and the complications of storing and retrieving information from the Cloud, and you start to comprehend the scale of the challenge.

The emergence of the political will to build a national broadband network with the capacity to deliver high-speed internet services to the majority of Australians is only a starting point. Gaining meaningful access to telehealth services will depend largely on how quickly the key role players embrace and invest in the networks that support them.

To ensure the effective implementation of telehealth, fibre optic backbones may need upgrading or installation to meet high-capacity requirements; wireless equipment needs to be installed in areas where existing cellular service may be lacking or fibre-to-the-home access is unavailable; and information switching and transport systems need to be modernised to carry multiple services.

If we start capping the ability of our core networks to deliver ‘adequate’ bandwidth for mission-critical applications like telehealth, we may find tomorrow’s Internet is hardly adequate at all. That will mean more investment, higher costs, and painful rebuilding, all of which could and should be avoided with the right level of investment and appropriate technology today.